Fact-sheet: Giant cell tumor tendon sheath ( extra articular PVNS )
Updated on 09/05/2019 at 9:29 AM
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Definition
Pigmented villonodular synovitis and tenosynovial giant cell tumor belong to the same tumor family.
Development arises from the synovium or the tendon sheath.
Second leading cause of soft tissue masses of the hand after ganglion cyst.
Clinical features
Painless, slow-growing cold swelling, mobile but adherent to deep structures. Size ranging from 5 mm to 5 cm.
Preferential location on the hand and wrist.
Predominance on the palmar aspect of the first three fingers.
Usually solitary.
Laboratory findings
Normal
Radiography
Normal, or shows soft tissue swelling, adjacent bone erosion, periosteal reaction, or rarely intratumoral calcifications.
Ultrasound
Solid, hypoechoic, homogeneous lesion with well-defined margins, non-mobile on dynamic maneuvers.
Doppler hyperemia.
CT
Same as conventional radiography.
MRI
Well-defined soft tissue lesion surrounding a classically normal tendon.
Hypointense on T1, heterogeneous on T2, hemosiderin deposition on gradient-echo.
Marked enhancement after gadolinium injection.
Possible cystic, avascular, satellite nodule, or diffuse form.
Management
Surgical resection.
Risk of recurrence.
Differential diagnosis
Hematoma.
Sarcoma.
Ganglion cyst.